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Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)

European heart journal, 2019-12, Vol.40 (47), p.3848-3855 [Peer Reviewed Journal]

The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. ;ISSN: 0195-668X ;EISSN: 1522-9645 ;DOI: 10.1093/eurheartj/ehz136 ;PMID: 30907409

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  • Title:
    Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)
  • Author: Roos-Hesselink, Jolien ; Baris, Lucia ; Johnson, Mark ; De Backer, Julie ; Otto, Catherine ; Marelli, Ariane ; Jondeau, Guillaume ; Budts, Werner ; Grewal, Jasmine ; Sliwa, Karen ; Parsonage, William ; Maggioni, Aldo P ; van Hagen, Iris ; Vahanian, Alec ; Tavazzi, Luigi ; Elkayam, Uri ; Boersma, Eric ; Hall, Roger
  • Is Part Of: European heart journal, 2019-12, Vol.40 (47), p.3848-3855
  • Description: Reducing maternal mortality is a World Health Organization (WHO) global health goal. Although maternal deaths due to haemorrhage and infection are declining, those related to heart disease are increasing and are now the most important cause in western countries. The aim is to define contemporary diagnosis-specific outcomes in pregnant women with heart disease. From 2007 to 2018, pregnant women with heart disease were prospectively enrolled in the Registry Of Pregnancy And Cardiac disease (ROPAC). Primary outcome was maternal mortality or heart failure, secondary outcomes were other cardiac, obstetric, and foetal complications. We enrolled 5739 pregnancies; the mean age was 29.5. Prevalent diagnoses were congenital (57%) and valvular heart disease (29%). Mortality (overall 0.6%) was highest in the pulmonary arterial hypertension (PAH) group (9%). Heart failure occurred in 11%, arrhythmias in 2%. Delivery was by Caesarean section in 44%. Obstetric and foetal complications occurred in 17% and 21%, respectively. The number of high-risk pregnancies (mWHO Class IV) increased from 0.7% in 2007-2010 to 10.9% in 2015-2018. Determinants for maternal complications were pre-pregnancy heart failure or New York Heart Association >II, systemic ejection fraction <40%, mWHO Class 4, and anticoagulants use. After an increase from 2007 to 2009, complication rates fell from 13.2% in 2010 to 9.3% in 2017. Rates of maternal mortality or heart failure were high in women with heart disease. However, from 2010, these rates declined despite the inclusion of more high-risk pregnancies. Highest complication rates occurred in women with PAH.
  • Publisher: England
  • Language: English
  • Identifier: ISSN: 0195-668X
    EISSN: 1522-9645
    DOI: 10.1093/eurheartj/ehz136
    PMID: 30907409
  • Source: GFMER Free Medical Journals
    Alma/SFX Local Collection
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